Determinants Of Breastfeeding Research Articles

Culture: A determinant of breastfeeding in SCPHN practice

The health benefits of breastfeeding are well researched and are recognised by professional bodies both nationally and globally, yet breastfeeding rates for many countries globally fall short of their respective national targets. Efforts have been made within both maternity services and Specialist Community Public Health Nursing (SCPHN) practice to provide training for professionals to improve breastfeeding rates, yet in many areas there remains a focus on the biological factors more than cultural beliefs, despite culture being widely accepted as an integral aspect of needs assessment in the field of SCPHN practice. This article explores the literature to identify cultural beliefs surrounding breastfeeding from both positive and negative perspectives, which further highlighted how SCPHNs can improve their practice in sensitively approaching this subject with new and expecting mothers. The purpose of this review was to identify the significance of culture as a determinant of breastfeeding and highlight potential methods for improving SCPHN practice in this area.

Patterns and determinants of breastfeeding and complementary feeding practices over the first year of life in a rural Gambian population

Background: Although breastfeeding is common in The Gambia, high rates of undernutrition in children under five highlight the importance of understanding drivers of particular feeding patterns in this environment, especially early introduction of non-breast milk foods (NBMFs). The country’s marked seasonality, which is associated with annual food insecurity and heavy maternal workload, may influence breastfeeding patterns; however, longitudinal assessments of infant diet in relationship to such factors are limited. We aimed to characterize infant breastfeeding patterns and timing of introduction of local complementary foods in a rural Gambian population across the first twelve months of life. Potential environmental and sociodemographic predictors of exclusive breastfeeding (EBF) duration were explored in order to identify factors that may influence infant feeding decisions in this population. Methods: Data from dietary questionnaires (administered every ten days until 12 months of age) collected as a part of the Hormonal and Epigenetic Regulators of Growth study (2013-2018) were used to calculate EBF duration in a subsample of 194 mother-infant pairs. Socioeconomic questionnaires and Principal Component Analysis were used to calculate household sociodemographic position (SEP). Multiple linear regression analyses were used to investigate potential predictors of EBF duration, including seasonality, SEP, and maternal and infant factors. Results: Mean age at introduction of food or liquid other than maternal milk was five months (±1.5). At twelve months, 98.7% of infants continue to receive some maternal milk. Being born in May significantly predicted shorter EBF duration by -1.68 months (95% CIs: -2.52, -0.84mo; P<.0001). SEP, maternal parity, and infant sex were non-significant predictors of EBF duration. Conclusions: Maternal milk is a vital component of infant diet across the first twelve months of life in this population. Earlier introduction of NBMFs coincides with the annual period where maternal agricultural workload intensifies in this region, though additional investigation is warranted.

Breastfeeding practices in Northeast China in 2008 and 2018: cross-sectional surveys to explore determinants over a decade

BackgroundThis study was conducted to investigate the prevalence and determinants of breastfeeding in 2008 and 2018, respectively, in Northeast China, where health service efficiency is at the lowest national level and regional data on breastfeeding are lacking. The influence of early initiation of breastfeeding on later feeding practices was specifically explored.MethodsData from the China National Health Service Survey in Jilin Province in 2008 (n = 490) and 2018 (n = 491) were analysed. Multistage stratified random cluster sampling procedures were used to recruit the participants. Data collection was conducted in the selected villages and communities in Jilin. Early initiation of breastfeeding was defined as the proportion of children born in the last 24 months who were put to the breast within one hour after birth in both the 2008 and 2018 surveys. Exclusive breastfeeding was defined as the proportion of infants 0–5 months of age who were fed exclusively with breast milk in the 2008 survey; while defined as the proportion of infants 6–60 months of age who had been fed exclusively with breast milk within the first six months of life in the 2018 survey.ResultsThe prevalence of early initiation of breastfeeding (27.6% in 2008 and 26.1% in 2018) and exclusive breastfeeding during the first six months (< 50%) were low in two surveys. Logistic regression revealed that exclusively breastfeeding at six months was positively associated with early initiation of breastfeeding (OR 2.65; 95% confidence interval (CI) 1.65, 4.26) and negatively associated with caesarean section (OR 0.65; 95% CI 0.43, 0.98) in 2018. Continued breastfeeding at one year and timely introduction of complementary foods were associated with maternal residence and place of delivery, respectively, in 2018. Early initiation of breastfeeding was associated with mode and place of delivery in 2018 but residence in 2008.ConclusionBreastfeeding practices in Northeast China are far from optimal. The negative effect of caesarean section and positive effect of early initiation of breastfeeding on exclusive breastfeeding suggest that an institution-based approach should not be substituted by the community-based one in the formulation of breastfeeding strategies in China.

Stemming commercial milk formula marketing: now is the time for radical transformation to build resilience for breastfeeding

Stemming commercial milk formula marketing: now is the time for radical transformation to build resilience for breastfeeding

Determinan Pemberian ASI Eksklusif di Masa New Normal oleh Ibu Menyusui yang Bekerja dengan Algoritma ID3

Breastmilk is exclusively an important activity in preparing a quality generation in the future. Nutrients in the form of breast milk that are sufficiently consumed by babies can affect the growth and development of babies. Sumber energy in the form of protein, vitamins and minerals in breast milk is the main source for babies. SDKI in 2017 showed that the coverage of ASIX administration for infants aged &lt; 6 months in Indonesia has generally increased in recent years, reaching 52%. this percentage decreases along with the increase in children's age, for children aged &lt; 1 month the percentage is 67%, this figure is reduced to 55% in children aged 2-3 months and decreases to 38% in children aged 4-5 months. One of the obstacles to the administration of ASIX is working mothers.&#x0D; The purpose of the study was to determine the Determinants ofBreastfeeding X in the New Normal Period by Breastfeeding Mothers Who Work with the ID3 Algorithm with Methods and Types of research conducted in this study using a quantitative approach. Quantitative data analysis was carried out in this study using the ID3 Algorithm.&#x0D; The results of the study with the ID3 algorithm obtained determinants of breastfeedingX from 6 variables: age, education, knowledge, facilities, income and family support, it was found that the knowledge variable is the variable that most affects the achievement of ASIX in working mothers. As for the variables of income, support facilities and education become accompanying variables.&#x0D; The conclusion of this study is that if knowledge is good, the variable that is the main inclusion is income. The income of families with the middle category will be seen facilities at their place of work, if there are facilities in their place of work, the possibility of breastfeedingX is achieved, but if there are no facilities in their place of work, family support and the last education of the mother will be seen.

Frequency and Determinants of Breastfeeding in Greece: A Prospective Cohort Study during the COVID-19 Pandemic.

Breastfeeding is considered to be the cornerstone of child health. In Europe however, overall breastfeeding rates remain low. The present study aimed at estimating the frequency of breastfeeding in Greece during the COVID-19 pandemic period and comparing findings with the latest national study in order to identify a potential impact of the pandemic. Additionally, possible correlations of socio-cultural and demographic characteristics with breastfeeding indicators were investigated. This prospective cohort study included 847 women from five tertiary maternity hospitals, between January and December 2020. Data were collected by a structured questionnaire via interview during hospitalization and via telephone in the first, third and sixth month postpartum. Results showed that all breastfeeding indicators improved over the last three years. Full breastfeeding reached 7.2%, contrary to 0.78% of the latest national study at six months postpartum. Employment, marital status, educational level, mode of delivery, type of maternity hospital, body mass index before pregnancy, previous breastfeeding experience of the mother and infant’s birth weight correlated significantly with breastfeeding indicators at different time periods. The COVID-19 pandemic seems to have favorably influenced breastfeeding initiation and duration in Greece due to lockdowns, home confinement and teleworking.

Making it \u201cwork\u201d: mothers\u2019 perceptions of workplace breastfeeding and pumping at Dutch universities

BackgroundDutch breastfeeding rates are below World Health Organization’s recommendations and targets despite the benefits for individuals and society. Increasing the rates is complex due to multiple breastfeeding determinants, of which maternal education and employment are dominant. This study aimed to identify the perceptions and experiences of mothers employed at Dutch universities regarding barriers and enablers to workplace breastfeeding and pumping.MethodsThe study adopted a descriptive, qualitative research design. Thirteen semi-structured online interviews, underpinned by the Social Ecological Model, were conducted in 2020 with three experts and ten academic employees from five universities who had breastfed or pumped at work within the past five years. Qualitative data were examined through a thematic analysis.ResultsFour main themes were identified: physical work environment, social support, work culture and organisation, policies and legal rights. Most mothers had more negative than positive experiences combining breastfeeding with work. They were unable to exercise their rights as a breastfeeding employee due to inappropriate and inaccessible lactation rooms, a lack of communication and information-provision, other people’s lack of awareness, inflexible working hours and unadjusted workloads, especially for teaching positions. All participants found the duration of Dutch maternity leave too short.ConclusionsUniversities need to increase institutional efforts at multiple levels and meet their legal obligations to support breastfeeding employees. Workplace interventions should be combined with more political commitment to normalise breastfeeding, monitor compliance with maternity protection provisions at work and prolong parental leave to encourage breastfeeding continuation.

Determinants of breastfeeding practice in Pujehun district, southern Sierra Leone: a mixed-method study

BackgroundIt is well established that exclusive breastfeeding can play a critical role in reducing child morbidity and mortality. Limited research has been done thus far on the practice and perceptions of breastfeeding in Sierra Leone, where more than 10 % of children die before the age of five. This study aimed to gain understanding into and explore both matters in order to develop recommendations for effective strategies to promote breastfeeding practice in Pujehun District, Southern Sierra Leone.MethodsThis exploratory mixed-method study included a cross-sectional survey of 194 mothers, semi-structured interviews and focus group discussions. Logistic regression analysis was used calculated odds ratios of factors associated with primarily breastfeeding practice, defined as ‘Children under six months of age who are fed with breast milk only and children older than six months of age that were exclusively breastfed up to six months’, based on recall from birth. Exclusive breastfeeding rate was based on breastfeeding practice 24 h prior to the survey. Qualitative data was analysed through a deductive approach, using a pre-determined framework on determinants of breastfeeding.ResultsThis study revealed an exclusive breastfeeding rate of 62.8% (95% CI 53.9, 71.7); dropping from 74% in the 0–1-month age group to 33% in the 4–5 months group. Triangulation of qualitative and quantitative data revealed enabling factors for primarily breastfeeding practice included mothers receiving support during their first breastfeed, pregnant women being provided with information on the benefits of the practice, counselling by nurses, support from husbands, and women’s awareness of how their friends and family members fed their own babies. The main barriers were a lack of encouragement by husbands, women’s perception that their infants’ stools were abnormal or that they were not producing enough breast milk.ConclusionsAlthough the exclusive breastfeeding may have risen over recent years, a gap remains compared to World Health Organization recommendations. According to the breastfeeding determinants identified in this study, promotion of counselling by a nurse, encouragement of husbands’ support, and improve knowledge of mothers on breastfeeding are recommended to be incorporated in the design of future health programs.

Individual and community-level factors influencing optimal breastfeeding: A multilevel analysis from a national survey study of Ethiopia.

BackgroundOptimal breastfeeding is critical for healthy growth of the child. Globally, 820,000 children and 20,000 women lost due to in appropriate breastfeeding each year. In Ethiopia, 50,000 children lost related to malnutrition with 18% were due to poor breastfeeding habit. Little is known on the determinants of breastfeeding with hierarchical level. Therefore, this study aimed to identify factors influencing optimal breastfeeding among children under six month in Ethiopia using a multilevel analysis.MethodsThe data of this study were obtained from Ethiopian Demographic and health survey conducted from January to June 2016. A total 1,087 children aged 0–5 months were selected using two stage stratified sampling technique. Multilevel logistic regression analysis was done to identify significant explanatory variables. Akaike information criteria were used to select the best model fit. Fixed effect was done to estimate the association between the outcome and explanatory variable and also random effect to measure the variation explained by the higher level.ResultAmong the total of 1,087 children, 45.4% were optimally breastfeed. Children from the richest wealth index (AOR = 2.87; 95% CI: 1.53–5.43) was positively associated with optimal breastfeeding but, children aged 4–5 months (AOR = 0.19; 95%CI: 0.12–0.27), children born through cesarean section (AOR = 0.18; 955 CI: 0.07–0.51) and residing in Afar region (AOR = 0.13; 95%CI: 0.02–0.92) were found inversely associated with optimal breastfeeding. The random-effects showed that the variation between communities was statistically significant.ConclusionIndividual and community level factors play a significant role in shaping optimal breastfeeding. Future strategies and health interventions should be strengthen to target individual and community level factors that enhance optimal breastfeeding.

Trends and determinants of breastfeeding within one hour in Ethiopia, further analysis of Ethiopian Demographic and Health Survey: multivariate decomposition analysis

BackgroundDespite the substantial efforts to improve timely/early initiation of breastfeeding, avoidance of colostrum, and delayed initiation of breastfeeding remains a big challenge in developing countries. Therefore, this study aimed to analyze the trends of early breastfeeding rate over time based on the Ethiopian Demographic and Health Survey (EDHS).MethodsSecondary data analysis was conducted based on the Ethiopian Demographic Health Surveys (EDHSs) conducted in 2005, 2011, and 2016. A total weighted sample of 9, 111, 10,106, and 8564 in 2005, 2011, and 2016 respectively were included for analysis. Trend and Logistic based decomposition analysis technique was used for analyzing the trends of early breastfeeding initiation over time and factors contributing to the change in early breastfeeding initiation rate. STATA 15 was employed for data management and analyses. All analyses presented in this paper were weighted for the sampling probabilities and non-response.ResultAmong children age less than 5 years the rate of early breastfeeding initiation rate overtime was increased from 70.5% in 2005 to 72.7% in 2016. The highest rate of improvement was seen in the second phase of the study (2011–2016) while it shows a decline in the first phase (2005–2011) from 70.5 to 55.1%. The decomposition analysis indicated that about half of the overall change in early breastfeeding initiation rate was due to the difference in women’s composition. Particularly, an increase in health facility delivery and vaginal delivery was a significant predictor of the increasing rate of early breastfeeding initiation over the surveys.ConclusionEarly initiation of breastfeeding slightly increasing over the last 10 years in Ethiopia. Half of the overall increase in the early initiation of breastfeeding was due to the change in compositional characteristics of women over 10 years in Ethiopia. Change in the composition of women according to health facility delivery and vaginal delivery were the major source of the increase in early breastfeeding initiation over time. Public interventions including promoting health facility delivery of women for further improvements of early breastfeeding initiation should be needed.

Exploring the Emotional Breastfeeding Experience of First-Time Mothers: Implications for Healthcare Support.

Background: Among breastfeeding determinants, the unique emotional breastfeeding experience has been poorly explored. The present study aimed to investigate the emotional breastfeeding experience in a cohort of first-time mothers.Materials and methods: We conducted a prospective observational study that enrolled primiparas having delivered singleton healthy term newborns, and exclusively breastfeeding at hospital discharge. At 3 months post-delivery mothers accessed an online questionnaire investigating their emotional breastfeeding experience. The chi-squared test was used to assess the association between the feelings experienced during breastfeeding and feeding outcomes at 3 months.Results: Out of the 421 enrolled mothers, 273 (65%) completed the questionnaire. At 3 months post-delivery exclusive breastfeeding was reported by a 66% of mothers, a 19% reported complementary feeding, and a 15% of mothers reported exclusive formula feeding. Breastfeeding experience was described as positive by 62% of mothers although breastfeeding difficulties were reported by 80% of the mothers. The mothers that had experienced fear, sadness, anger or concern during breastfeeding showed a significant higher exclusive formula feeding rate at 3 months post-delivery than those who did not (25.5 vs. 12.8%, p = 0.021; 28.6 vs. 13.4%, p = 0.02; 40 vs. 13.4%, p = 0.005; 20.5 vs. 11.8%, p = 0.049, respectively). An 85% of mothers stated that their breastfeeding experience was different from what they would have expected, blaming for this discrepancy the occurrence of difficulties during breastfeeding and the complexity of breastfeeding itself (50%), pain experience (8%), being dependent from the baby (6%), and breastfeeding failure (11%). A total of 25% of mothers, however, reported they found breastfeeding to be a much more positive experience than what they had expected.Conclusion: Breastfeeding care should include a tailored emotional support of first time-mothers in addition to the implementation of their breastfeeding knowledge and skills.

Breastfeeding practices 2008\u20132009 among Chinese mothers living in Ireland: a mixed methods study

BackgroundMigration to another country has a potential influence on breastfeeding practices. A significant difference in breastfeeding rates between Irish nationals and non-nationals has been reported. This study was conducted to explore breastfeeding practices of the Chinese in Ireland, one of the largest Irish ethnic groups, and to explore the influence of living in Ireland on breastfeeding practices. This is the first and the only migration study so far on breastfeeding practices among the Chinese in Ireland.MethodsA sequential explanatory mixed methods approach was adopted. The first phase was a cross-sectional self-administered retrospective mailed survey, to explore breastfeeding practices and determinants of breastfeeding among a convenience sample of Chinese mothers living in Ireland (n = 322). Recruitment was conducted in the Dublin metropolitan area, with the application of the snowball technique to increase sample size. The second phase consisted of seven semi-structured focus groups (n = 33) conducted in Dublin, to explore the influence of living in Ireland on breastfeeding among Chinese mothers who had given birth in Ireland. Quantitative data were analyzed by univariate and multivariate logistic regression analyses, and informed the qualitative data collection. Qualitative data were analyzed by thematic content analyses, to explain and enrich the qualitative results.ResultsThe breastfeeding initiation rate among Chinese immigrants to Ireland who gave birth in Ireland (CMI) (75.6%) was high and close to that of Chinese immigrant mothers who gave birth in China (CMC) (87.2%). However, giving birth in Ireland was independently associated with a shorter duration of breastfeeding (< 4 months) among Chinese immigrants. Qualitative results explained that a shorter breastfeeding duration among CMI than that of CMC was mainly due to cultural conflicts, a lack of family support, language barriers, immigrants’ low socioeconomic status, and mothers’ preference for infant formula on the Irish market. Both quantitative and qualitative data revealed a strong cultural belief in the efficacy of the traditional Chinese postpartum diet for breast milk production for both CMC and CMI. Antenatal feeding intention was a strong determinant for breastfeeding initiation and duration among CMI.ConclusionMigration to Ireland was found to be associated with a shorter duration of breastfeeding of the Chinese. Culturally sensitive and language-specific education and support of breastfeeding is needed for the Chinese mothers living in Ireland. The mixed methods design presented here might serve as a template for future migration research on breastfeeding.

Information and Communication Systems to Tackle Barriers to Breastfeeding: Systematic Search and Review.

BackgroundBreastfeeding has many benefits for newborns, mothers, and the wider society. The World Health Organization recommends mothers to feed newborns exclusively with breastmilk for the first 6 months after birth, but breastfeeding rates in many countries fail to align with the recommendations because of various barriers. Breastfeeding success is associated with a number of determinants, such as self-efficacy, intention to breastfeed, and attitudes toward breastfeeding. Information and communication technology (ICT) has been leveraged to support breastfeeding by means of improving knowledge or providing practical supports in different maternal stages. Previous reviews have examined and summarized the effectiveness and credibility of interventions; however, no review has been done from a human-computer interaction perspective that is concerned with novel interaction techniques and the perspective of end users.ObjectiveThe objective of this review was to provide a comprehensive overview of existing digital interventions that support breastfeeding by investigating systems’ objective, technology design, validation process, and quality attributes, both in terms of clinical parameters as well as usability and user experience.MethodsA systematic search was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in the following libraries: PubMed, Science Direct, Association for Computing Machinery Digital Library (ACM Digital Library), and Institute of Electrical and Electronics Engineers Xplore (IEEE Xplore).ResultsA total of 35 papers discussing 30 interventions were included. The main goals of these interventions were organized into 4 categories: breastfeeding education (n=12), breastfeeding promotion (n=8), communication support (n=6), and daily practical support (n=4). Of the interventions, 13 target mothers in the postnatal period. Most interventions come in forms of client communication systems (n=18), which frequently leverage Web technologies, text message, and mobile apps to provide breastfeeding support. Systems predominantly focus on mothers; validation strategies were rather heterogeneous, with 12 user studies concerning usability and user experience and 18 clinical validation studies focusing on the effects of the interventions on breastfeeding determinants; 5 papers did not report results. Generally, straightforward systems (eg, communication tools or Web-based solutions) seem to be more effective than complex interventions (eg, games).ConclusionsExisting information and communication systems offer effective means of improving breastfeeding outcomes, but they do not address all relevant periods in parenthood (eg, the antenatal period) and often do not involve important stakeholders, such as partners. There is an opportunity to leverage more complex technical systems to open up avenues for the broader design of ICT to support breastfeeding; however, considering evaluation outcomes of existing support systems of higher complexity, such systems need to be designed with care.

Milk expression and maternity leave as determinants of breastfeeding among mothers employed in a baby friendly hospital

This study aimed to evaluate breastfeeding behaviors among healthcare professional mothers employed in a hospital which support Baby Friendly Hospital (BFH) Initiative program. Methods: This cross-sectional and descriptive study was performed in Erciyes University Hospital between August 2011 and June 2012. 175 healthcare professional mothers who had 1-5 years old children recruited for the study. Data was collected via a questionnaire which contains 51 questions. The rate of exclusive breastfeeding (EB) was 33.1% among healthcare professional mothers employed in a BFH. The mean of total breastfeeding duration was 13.02±7.53 months. The rates of cesarean delivery and initiation breastfeeding in an hour were 77.7% and 61.7% respectively of the study group. Vaginal delivered mothers’ breastfeeding rates in first one hour (79.5%) were significantly higher than caesarean delivered mothers’ (56.6%) (p

Determinants of breastfeeding discontinuation in an Italian cohort of mother-infant dyads in the first six months of life: a randomized controlled trial

BackgroundAmong breastfeeding determinants, the marketing of breast milk substitutes might contribute to suboptimal breastfeeding rates. The aim of this study was to investigate the effect of receiving information on breast milk substitutes on breastfeeding rates.MethodsWe conducted a randomized, single-blind, controlled trial from 2012 to 2014 in a northern Italian maternity ward. We enrolled 802 Caucasian mothers who gave birth to healthy, full-term singletons with a birth weight > 2500 g and who were exclusively breastfeeding from delivery to discharge. Mothers who gave birth to infants with congenital diseases, chromosomal abnormalities, perinatal infections and/or cardio-respiratory instability and/or mothers being affected by endocrine and/or metabolic and/or gastrointestinal and/or renal diseases were excluded.Mothers were randomized to either receive (group A, n = 405) or not (group B, n = 397) written information on a breast milk substitute at discharge. Breastfeeding was promoted and supported in all mother-infant pairs equally. The mode of feeding for up to 6 months after delivery was determined by phone interview. To detect a 10% difference between groups in the discontinuation rate of exclusive breastfeeding at three months of age at 5% significance and 80% power, a total of 356 mother-infant pairs per group were needed.ResultsThe exclusive breastfeeding prevalence was 91% and 92% at 7 days, 79% and 70% at 1 month, 75% and 66% at 2 months, 72% and 62% at 3 months, and 3% and 2% at 6 months in groups A and B, respectively. The relative risk (95% confidence interval) of exclusive breastfeeding (group A vs B) at 7 days and at 1, 2, 3 and 6 months was as follows: 0.99 (0.95–1.03), 1.12 (1.03–1.21), 1.13 (1.03–1.24), 1.15 (1.04–1.27), and 1.49 (0.62–3.61).Nutritional, lifestyle and lactational factors were the primary contributing determinants to early breastfeeding discontinuation.ConclusionsThe present findings indicate that receiving written information on breast milk substitutes at hospital discharge, provided that breastfeeding support and education are offered, does not negatively affect breastfeeding rates.Trial registrationNCT03208114. Registered 5 July 2017.

Maternal weight status, diet, and supplement use as determinants of breastfeeding and complementary feeding: a systematic review and meta-analysis.

Infant feeding practices are influenced by maternal factors. The aim of this review is to examine the associations between maternal weight status or dietary characteristics and breastfeeding or complementary feeding. A systematic literature search of the Embase, Cochrane Library, Google Scholar, MEDLINE, PubMed, and Web of Science databases was performed. Interventional and cohort studies in healthy mothers and infants that reported on maternal weight status, diet, or supplement use were selected. Outcomes assessed included delayed onset of lactogenesis; initiation, exclusivity, duration, and cessation of breastfeeding; and timing of complementary feeding. Eighty-one studies were included. Maternal underweight, diet, and supplement use were not associated with infant feeding practices. Obese women had a relative risk of failure to initiate breastfeeding (risk ratio [RR] = 1.23; 95%CI, 1.03-1.47) and a delayed onset of lactogenesis (RR = 2.06; 95%CI, 1.18-3.61). The RR for breastfeeding cessation was 1.11 (95%CI, 1.07-1.15) per increase in category of body mass index. Prevention of obesity in women of reproductive age, as well as counseling of obese women after delivery, could be targeted to improve infant feeding practices.

A hospital-based study on determinants of breast-feeding initiation practices in post-natal ward of a tertiary care hospital

Background: Increasing evidence has highlightened the importance of initiation of breast feeding and its continuation in infancy. The global community recommends and promotes exclusive breast feeding as the method of choice especially for first six months of life. The study outcome will reveal important factors of determinants of breast feeding which in turn will be baseline data for formulation of public health policies pertaining to it. Objective: To study the determinants of exclusive breast feeding in newborn infants in a tertiary care hospital in Kashmir valley. Material and Methods: A hospital-based descriptive cross-sectional study design was conducted among lactating women in post-natal ward who had delivered at Trust Hospital, Sheri-Kashmir Institute of Medical Sciences, Soura, J&K, for a period of 4 months (October 13–January 14). The study population consisted of 720 mothers with their babies who attended the hospital during the study period out of which 218 were selected through non-probability convenient sampling method. Obstetric/health service-related factors, breast feeding initiation practices, and difficulties faced were assessed for any influence on exclusive breast feeding. Results: A total of 218 mothers with their infants were included and belonged to 25–34 years of age group. Majority (95.4%) of newborns received exclusive breast feeding. Further it was found that the factors like parity, mode of delivery, antenatal counseling had a significant impact on type of breast feeding (P < 0.05). Conclusion: Exclusive breast feeding prevalence rate revealed in our study was more than the national level which indicates comparatively better feeding practices in our hospital. Further the factors classically found as supportive for breast feeding had shown association with exclusive breast feeding pattern.

Determinants of exclusive breastfeeding and introduction of complementary foods in rural Egyptian communities.

Background:Determinants of breastfeeding (BF) exclusivity at a rural Egyptian setting are largely unknown. This cross-sectional study aimed to assess BF indicators, specifically exclusivity and the timely complementary feeding while assessing potential determinants that affect exclusivity of BF among a sample of mothers inhabiting Egyptian rural communities.Methods:A community based cross-sectional study was carried out over a period of four months with inclusion of 1000 eligible women having infants aged less than two years through a multi-stage random sampling method. Personal interview, using structured questionnaire, to collect information on socio-demographic characteristics, antenatal care services, women’s lactation practices, complementary feeding practices and knowledge about BF.Results:All the included mothers had breastfed their infants, and 32.4% of them initiated BF within the first hour of life and 29.9% exclusively breastfed their infants for 6 months after birth. Complementary feeding was introduced for children aged 6-9 months in 63.6% of them. Bivariate analysis showed that factors favoring exclusive BF were age of the mother (<25 years), with secondary or higher education, number of children, with no history of complicated pregnancy or lactation problems, received health education about BF and having knowledge about BF. Logistic regression model showed that most influential significant predictor for exclusive BF was receiving of health education about BF and adequate knowledge of BF.Conclusions:Although all rural Egyptian mothers included, initiated BF, the rate of its exclusivity was low. Comprehensive education about BF during pregnancy is strongly needed to promote BF among them.

Patterns and determinants of breastfeeding and complementary feeding practices of Emirati Mothers in the United Arab Emirates.

BackgroundBreastfeeding is the preferred method of feeding for the infant. The present study aimed at investigating the different infant feeding practices and the influencing factors in the United Arab Emirates (UAE).MethodsA convenient sample of 593 Emirati mothers who had infants up to 2 years of age was interviewed. The interviews included a detailed questionnaire and conducted in the Maternal and Child Health Centers (MCH) and Primary Health Centers (PHC) in three cities.ResultsAlmost all the mothers in the study had initiated breastfeeding (98%). The mean duration of breastfeeding was 8.6 months. The initiation and duration of breastfeeding rates were influenced by mother’s age (P<0.034)and education(P<0.01), parity(OR=2.13; P<0.001), rooming in(OR=21.70; P<0.001), nipple problem(P<0.010) and use of contraception(P<0.034). As for the feeding patterns, the results of the multiple logistic analyses revealed that rooming in (OR=4.48; P<0.001), feeding on demand (OR=2.29; P<0.005) and feeding more frequently at night (P<0.001) emerged as significant factors associated with exclusive or predominantly breastfeeding practices. Among the 593 infants in the study, 24.1% had complementary feeding, 25% of the infants were exclusively breastfed, and 49.4% were predominantly breastfed since birth. About 30% of the infants were given nonmilk fluids such as: Anis seed drink (Yansun), grippe water and tea before 3 months of age. The majority of the infants (83.5%) in the three areas received solid food before the age of 6 months. A variety of reasons were reported as perceived by mothers for terminating breastfeeding. The most common reasons were: new pregnancy (32.5%), insufficient milk supply (24.4%) and infant weaned itself (24.4%).ConclusionsIn conclusion, infant and young child feeding practices in this study were suboptimal. There is a need for a national community-based breastfeeding intervention programme and for the promotion of exclusive breastfeeding as part of a primary public health strategy to decrease health risks and problems in the UAE.

Alimentação nos primeiros três meses de vida

Breastfeeding duration and the factors that make it a successful practice are extreme relevant topics. Based on the evidence of the benefits of exclusive breastfeeding and because of the intensive campaign in favor of this practice in Brazil by means of different policies and programs that have been implemented over the last three decades, promoting periodical updates of the knowledge about the epidemiology of early weaning is crucial (1-3) . One of the highlights of the March issue of Revista Paulista de Pediatria is the article by Cristina Kaufmann, Elaine Albernaz, Regina Silveira, and Maria Mascarenhas on infant feeding (4) . The objectives of this study were: to assess the dietary profile in the first three months of life, to identify factors related to the weaning/early introduction of complementary foods, and to evaluate the adequacy of the use of utensils during this period. The authors used a cohort study design with two compo- nents: perinatal stage (screening at hospital) and follow-up stage (home visits at one and three months of age). Data were collected by means of interviews with the mothers of babies born between September 2002 and May 2003. Home visits covered 30% of randomly selected infants. The final sample included 2,741 mothers. Of these, 973 were selected for home follow-up. The study suggests only 60% of prevalence of exclu- sive breastfeeding in the first month, and 39% in the third month. Such data demonstrate that infants from the city of Pelotas are inadequately fed. In the first month of life, 10% of infants had already been weaned, and in the third month, this figure had tripled. In spite of such low breastfeeding rate, when compared with previous decades, such data show an increase in the duration of breastfeed- ing in Pelotas, which is in agreement with what has been found in other regions of the country. Therefore, these data demonstrate that breastfeeding protection initiatives have led to decreased early weaning. This finding is essential to ensure that the existing programs and policies are main- tained and broaden in Brazil. Paternal educational level, intention to breastfeed, smoking during pregnancy, and use of pacifier were found to be risk factors for weaning in the first month of life. The risk factors for weaning in the third month of life were: paternal educational level, Caucasian mother, the fact that the mother lived with a partner, intention to breastfeed, smoking during pregnancy, use of pacifier, and bottle- feeding. Both models contribute to a better understanding of the determinants of breastfeeding. Since breastfeeding consists of a complex process involving the mother-child pair and their insertion into the family and society, its causal behavior has a different influence on breastfeeding establishment during the neonatal period and its mainte- nance in the subsequent months.